ENRIQUE BALLESTEROS

FARMINGTON, CT
NPI1972594497
Former NameHENRY BALLESTEROS
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology
(Licence: CT  039969)
Enumeration Date2005-11-03
Last Update Date2022-11-07
Business Address
Dr. ENRIQUE BALLESTEROS M.D.
263 FARMINGTON AVE
FARMINGTON, CT 06030-3985
Phone number: 860-679-2980
Mailing Address
Dr. ENRIQUE BALLESTEROS M.D.
263 FARMINGTON AVE PROVIDER ENROLLMENT
FARMINGTON, CT 06030-2212
Phone number: 860-679-7503